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THIS CERTIFICATE IS ISSUED AS <br />CERTIFICATE DOES NOT AFFIRN <br />BELOW. THIS CERTIFICATE OF <br />REPRESENTATIVE OR PRODUCER <br />wnume[e nower an <br />SUBROGATION IS WAIVED, subject tIs the <br />PRODUCER <br />Lockton Companies, LLC <br />5847 San Felipe, Suite 320 <br />Houston, TX 77057 <br />INSURED <br />Insperity, Inc. L/CIF <br />KOSMONT 8 ASSOCIATES, INC. <br />19001 Crescent Springs Drive <br />Kingwood, TX 77339 <br />COVERAr P-Q <br />FICATE OF LIABILITY INSURANCE DATE IMWDDIYYYYI <br />Acd . 11713M 10/29/2019 <br />1 OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THEI CERTIFICATE HOLDER. THIS <br />)R NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />:E DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />CERTIFICATE HOLDER, <br />DITIONAL INSURED, the pOliCy(ies) must have ADDITIONAL INSURE Provlsions or be endorsed. If <br />ms and conditions of the policy, certain policies may require an end mement. A statement on this <br />ate holder in lieu of such e_ndorsement(s). <br />NAME• <br />T 888-828-8366 <br />Ace American Insurance Co. 22667 <br />THIS IS TO CERTIFY THAT THE POLICIE <br />INDICATED. NOTWITHSTANDING ANY R <br />CERTIFICATE MAY BE ISSUED OR MAY <br />EXCLUSIONS AND CONDITIONS OF SUC <br />ILTRISR TYPE OF INSURANCE <br />OF IN <br />QUIRE <br />PERTA14, <br />POLICIES. <br />A L <br />REVISION UMBER: <br />URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A 0VE FOR THE POLICY PERIOD <br />ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT ARTH RESPECT TO WHICH THIS <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />BR POLICY EFF POLICY EXP — <br />POLICYNUMBER MMIDD/YYYY metro LIMITS <br />EACH OCCUR 3ENCE 6 <br />A ---.. <br />GENERAL LIABILITY <br />_ <br />CLAIMS -MADE OCCUR <br />PREMISE E Occune ce S <br />_-- — <br />MED EXP(Ari one arson $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />_ <br />PERSONALS OVINJURY $ <br />POLICY ❑ JEC LOC <br />GEERAL AG REGATE S <br />PRODUCTS- OMPIOP AGG I $ <br />OTHER: <br />—LIMIT— <br />AUTOMOBILE LIABILITY <br />$ <br />-I <br />COMBINED IIIGLE <br />ANY AUTO <br />;_LEa eccitlent 5_ <br />ALLOWNED SCHEDULED <br />AUTOS AUTOS <br />j BODILY INJUR r(Fet person) I S <br />FoDILYINJUR <br />NON-0WNED <br />(Parevgtlss) $ <br />HIRED AUTOS <br />- AUTOS <br />PROPERPMAGEE — - <br />K <br />UMBRELLA DAB y OCCUR <br />$ <br />EXCESS DAB <br />_. CLAIM:LMAOE <br />- <br />EACH OCCUR ENCE S <br />-- <br />AGGREGATE g <br />DED RETENTION$ <br />WORKERS COMPENSATION <br />S <br />AND EMPLOYERS' LIABILITY YIN <br />X PER OT <br />STA.T_UTE' <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />A OFFICERIMEMBE EXCLUDED, <br />NIA <br />— I ER <br />i(Mantlatory In NH) <br />I C66712679 10/1/2019 10/1/2020 EL EACH ACCIDENT $ t.D00.D00 <br />Il yyes. tlescebe antler <br />DESCRIPTION OF OPERATIONS be. <br />E.L. DISEASE_ FA EMPLOYE $ i,000,t1(1p <br />- - <br />_ E.L. DISEASE -POLICY LIMIT S t,o00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHIC <br />Norm to OMera Endcreemenl Inducoc <br />ES (ACC <br />RO M. Atltlleonal Remarb $bhetlula. may M a8achetl if more apace la re9elredl <br />WAIVER OF SUBROGATION IN FAVOR OF CITY OF S <br />NTAA <br />MEN REQUIRED BY WRITTEN CONTRACT <br />CERTIFICATE HOLDER <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA 4TH <br />SANTA ANA, CA 92701 <br />a.nnt.cLLA I IVN <br />P4 AP -RpyEp _ - <br />jEMEM DIVISION SHOULD ANY OF THE ABOVE DESCRIB O POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED <br />IN ACC" TCE WITH THE POLICY PROVISIONS. <br />4 2019 <br />M, LAMBERT <br />AUTHORIZED REPRESENTATIVE <br />} <br />RD ODRPORATION <br />ACORD 25 (2016/03) I The .I1CORD name and logo are registered marks of ACORD . All rights reservE <br />